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BACKGROUND: Cardiac arrest is a common and devastating emergency of both the heart and brain. More than 380,000 patients suffer out-of-hospital cardiac arrest annually in the USA. Induced cooling of comatose patients markedly improved neurological and functional outcomes in pivotal randomized clinical trials, but the optimal duration of therapeutic hypothermia has not yet been established. METHODS: This study is a multi-center randomized, response-adaptive, duration (dose) finding, comparative effectiveness clinical trial with blinded outcome assessment. We investigate two populations of adult comatose survivors of cardiac arrest to ascertain the shortest duration of cooling that provides the maximum treatment effect. The design is based on a statistical model of response as defined by the primary endpoint, a weighted 90-day mRS (modified Rankin Scale, a measure of neurologic disability), across the treatment arms. Subjects will initially be equally randomized between 12, 24, and 48 h of therapeutic cooling. After the first 200 subjects have been randomized, additional treatment arms between 12 and 48 h will be opened and patients will be allocated, within each initial cardiac rhythm type (shockable or non-shockable), by response adaptive randomization. As the trial continues, shorter and longer duration arms may be opened. A maximum sample size of 1800 subjects is proposed. Secondary objectives are to characterize: the overall safety and adverse events associated with duration of cooling, the effect on neuropsychological outcomes, and the effect on patient-reported quality of life measures. DISCUSSION: In vitro and in vivo studies have shown the neuroprotective effects of therapeutic hypothermia for cardiac arrest. We hypothesize that longer durations of cooling may improve either the proportion of patients that attain a good neurological recovery or may result in better recovery among the proportion already categorized as having a good outcome. If the treatment effect of cooling is increasing across duration, for at least some set of durations, then this provides evidence of the efficacy of cooling itself versus normothermia, even in the absence of a normothermia control arm, confirming previous RCTs for OHCA survivors of shockable rhythms and provides the first prospective controlled evidence of efficacy in those without initial shockable rhythms. TRIAL REGISTRATION: ClinicalTrials.gov NCT04217551. Registered on 30 December 2019.

Scholars and policymakers have tried for years to solve the tenacious and harmful crisis of low-quality, erroneously granted patents. Far from resolving the problem, these determined efforts have resulted in hundreds of conflicting policy proposals, failed congressional bills, and no way to evaluate the policies’ value or impact or to decide between the overwhelming multiplicity of policies. This Article provides not only new solutions but a new approach for designing and assessing policies both in patent law and legal systems more generally. We introduce a formal economic model of the patent system that differs from existing scholarship because it permits us to (1) determine how a policy change to one part of the patent system affects the system as a whole and (2) quantify the impact of policy changes. Existing scholarship typically analyzes a policy by assessing its effect on just the targeted element of the patent system, but legal systems are complex with interrelated components, and players react along multiple margins, so these analyses are incomplete and sometimes incorrect. Our approach fixes this problem, providing a comprehensive understanding of how a policy change affects the patent system from beginning to end. It also permits us to conduct complex analyses such as varying multiple policies at once. Further, much existing scholarship fails to quantify the magnitude of a policy’s effect, and even empirical scholarship can only measure the effect of an already-implemented policy, not predict the effect of a proposed change. Quantification is critical because policies generally have multiple effects, often in countervailing directions. Quantification—as shown using our model—permits scholars to determine the overall direction and size of a theoretically ambiguous effect. Quantification also allows us to compare the social welfare effects of different reforms so that policymakers know where to focus their efforts. We apply our model to several of the most prominent policy debates in patent law. We conclude that certain reforms, such as regulation of settlement licenses and increased examination intensity, yield large gains in social welfare and should be prioritized. Other reforms that are popular with scholars, including decreasing the availability of injunctions and reducing litigation costs, produce surprisingly small gains in social welfare. Often, existing scholarship operates too much on intuition which, we show, can be wrong. Our new approach to patent reform provides an approach that offers deeper understanding and a more effective evaluation framework.

Johanna Boretzki,1,2 Eva Wolf,3 Carmen Wiese,4 Sebastian Noe,4 Annamaria Balogh,3 Anja Meurer,5 Ivanka Krznaric,6 Alexander Zink,7 Christian Lersch,1 Christoph D Spinner1,2 1Department of Medicine II, University Hospital Klinikum rechts der Isar, Munich, 2German Center for Infection Research, Partner Site Munich, 3MUC Research, Munich, 4MVZ Karlsplatz, HIV Clinical Care Center, Munich, 5Center for Infectiology and Internal Medicine, Munich, 6Center for Infectiology Prenzlauer Berg, Berlin, 7Department of Dermatology and Allergology, University Hospital Klinikum rechts der Isar, Munich, Germany Background: Reasons for and frequency of nonadherence to antiretroviral therapy (ART) may have changed due to pharmacological improvements. In addition, the importance of known non-pharmacologic reasons for nonadherence is unclear.Methods: We performed a cross-sectional, noninterventional, multicenter study to identify current reasons for nonadherence. Patients were categorized by physicians into the following adherence groups: good, unstable, or poor adherence. Co-variables of interest included age, sex, time since HIV diagnosis, ART duration, current ART regimen, HIV transmission route, comorbidity, HIV-1 RNA viral load (VL), and CD4 cell count. Patients self-reported the number of missed doses and provided their specific reasons for nonadherent behavior. Statistical analyses were performed using Fisher’s extended exact test, Kruskal–Wallis test, and logistic regression models.Results: Our study assessed 215 participants with good (n=162), unstable (n=36), and poor adherence (n=17). Compared to patients with good adherence, patients with unstable and poor adherence reported more often to have missed at least one dose during the last week (good 11% vs unstable 47% vs poor 63%, p

Abstract Background Weight stigma among healthcare professionals is associated with negative health impacts on patients, yet there are few effective strategies to combat weight stigma among health professional learners. The Body Advocacy Movement-Health (BAM-Health) is a novel group-based, peer-led stigma reduction intervention for health professional students that targets weight stigma across intrapersonal, interpersonal, and structural levels. The present study (1) assesses short-term impacts of BAM-Health participation on intrapersonal and interpersonal weight bias compared to an informational brochure control condition and (2) explores the feasibility and acceptability of BAM-Health among a sample of health professional students. Methods Sixty-seven health professional students participated in BAM-Health (n = 34) or received an informational brochure about weight stigma (n = 33). Participants completed validated self-report surveys assessing internalized weight/ appearance concerns and interpersonal weight stigma prior to their assigned intervention (baseline), immediately following intervention (post-intervention), and four weeks after intervention (follow-up). Baseline to post-intervention and baseline to follow-up effect sizes on each measure were calculated. At post-intervention, participants completed feedback surveys for thematic assessment. Results BAM-Health participation had a large baseline to post-intervention effect on internalized weight/ appearance concerns that diminished slightly at follow-up (Cohen’s d = -0.88; d = -0.62). Receipt of the informational brochure had a small effect on internalized weight/ appearance concerns (d = -0.27); however, these changes were not sustained at follow-up (d = 0.04). BAM-Health participation resulted in reductions in interpersonal obesity stigma and anti-fatness with small effect sizes (d = -0.32; d = -0.31). The effect on obesity stigma was slightly amplified at follow-up (d = -0.43); however, decreases in anti-fatness were not sustained (d = -0.13). The brochure condition failed to demonstrate effects on anti-fatness (d = 0.13, d = 0.14) or obesity stigma (d = -0.12; d = -0.12) at either time point. Between-session attrition rates of 4.5%, favorable quantitative ratings on post-session acceptability surveys, and free responses demonstrating appreciation of the virtual group environment and session activities reflect feasibility and acceptability of BAM-Health. Conclusions BAM-Health is a novel peer-led intervention that aims to reduce weight stigma among health professional students. BAM-Health met feasibility benchmarks and received positive feedback from participants, demonstrating acceptability and indicating interest among health professional students in analyzing and reducing weight stigma in their personal lives and careers. The intervention led to promising decreases in internalized and interpersonal weight stigma at post-intervention, some of which were sustained at follow-up. However, lack of effect on internalized weight/ appearance concerns measures may indicate that BAM-Health participants are more likely to reject weight stigma directed toward others following intervention, while maintaining thin ideals for themselves. Further investigation of BAM-Health with a larger sample and continued program development is warranted.

Abstract Adaptive sampling and situational awareness are key features of modern autonomous underwater vehicles (AUVs) since data quality can be improved while operation time and cost can be reduced. An example for adaptive sampling in the marine environmental context is thermocline detection and tracking. The thermocline as horizontal ocean layer separates warm and cold water and is a key feature in many marine disciplines. For example, it influences the distribution and exchange of nutrients and is a habitat for many organisms. In this paper we use an unscented Kalman Filter (UKF) based extremum seeking control (ESC) to find and follow ocean layers such as the thermocline. Computer simulations and real-world tests show that the method is able to find and track non-trivial real-world ocean layers with sensors subject to hysteresis and delay effects.

This study aimed to determine the protein requirements of the fattening phase for Nile tilapia (Oreochromis niloticus) fed fish meal-free diets. A total of 75 Nile tilapia were maintained in a water recirculation system, and five isoenergetic diets were formulated with increasing protein levels encompassing three repetitions each. The findings revealed that protein levels significantly affected (p < 0.05) certain Nile tilapia performance, yield, and composition parameters. The determined parameter values clearly indicated that Nile tilapia can be fed fish meal-free soybean meal and corn-based diets. Furthermore, the metabolic plasticity of this species concerning dietary protein concentrations was also demonstrated, with adequate performance results achieved in treatments containing from 267 to 294 g/kg digestible protein (DP), or 298 to 327 g/kg crude protein (CP), where the balance between essential and non-essential amino acids and energy resulted in adequate performance correlated to satisfactory feed conversion values and filet yields and composition. A DP concentration of 267 g/kg (298 g/kg CP) is recommended when offering corn and soybean meal-based diets during the Nile tilapia fattening phase to fish weighing between 400 and 700 g.

Abstract Purpose Neuroblastoma, the most common extracranial solid tumor in children under 5 years, often surrounds visceral arteries. This study aimed to analyze the working space provided by standardized surgical techniques at key arterial landmarks in adult cadavers. Methods We assessed in eight adult cadavers the mobilization of the left colon, spleen and pancreas, right colon, duodenum and mesenteric root, access to the bursa omentalis. The average working space score (AWSS) was evaluated at the left and right renal artery, left and right side of the coeliac trunk, superior mesenteric and common hepatic artery. The score was defined as: (0) vessel not visible, (1) working space at the vessel ≤ 1x diameter of the aorta, (2)

Abstract Here, we show that combined use of the EZH2 inhibitor GSK126 and the CDK4/6 inhibitor abemaciclib synergistically enhances antitumoral effects in preclinical GBM models. Dual blockade led to HIF1α upregulation and CalR translocation, accompanied by massive impairment of mitochondrial function. Basal oxygen consumption rate, ATP synthesis, and maximal mitochondrial respiration decreased, confirming disrupted endoplasmic reticulum-mitochondrial homeostasis. This was paralleled by mitochondrial depolarization and upregulation of the UPR sensors PERK, ATF6α, and IRE1α. Notably, dual EZH2/CDK4/6 blockade also reduced 3D-spheroid invasion, partially inhibited tumor growth in ovo, and led to impaired viability of patient-derived organoids. Mechanistically, this was due to transcriptional changes in genes involved in mitotic aberrations/spindle assembly (Rb, PLK1, RRM2, PRC1, CENPF, TPX2), histone modification (HIST1H1B, HIST1H3G), DNA damage/replication stress events (TOP2A, ATF4), immuno-oncology (DEPDC1), EMT-counterregulation (PCDH1) and a shift in the stemness profile towards a more differentiated state. We propose a dual EZH2/CDK4/6 blockade for further investigation.

Abstract Background Cardiac arrest is a common and devastating emergency of both the heart and brain. More than 380,000 patients suffer out-of-hospital cardiac arrest annually in the USA. Induced cooling of comatose patients markedly improved neurological and functional outcomes in pivotal randomized clinical trials, but the optimal duration of therapeutic hypothermia has not yet been established. Methods This study is a multi-center randomized, response-adaptive, duration (dose) finding, comparative effectiveness clinical trial with blinded outcome assessment. We investigate two populations of adult comatose survivors of cardiac arrest to ascertain the shortest duration of cooling that provides the maximum treatment effect. The design is based on a statistical model of response as defined by the primary endpoint, a weighted 90-day mRS (modified Rankin Scale, a measure of neurologic disability), across the treatment arms. Subjects will initially be equally randomized between 12, 24, and 48 h of therapeutic cooling. After the first 200 subjects have been randomized, additional treatment arms between 12 and 48 h will be opened and patients will be allocated, within each initial cardiac rhythm type (shockable or non-shockable), by response adaptive randomization. As the trial continues, shorter and longer duration arms may be opened. A maximum sample size of 1800 subjects is proposed. Secondary objectives are to characterize: the overall safety and adverse events associated with duration of cooling, the effect on neuropsychological outcomes, and the effect on patient-reported quality of life measures. Discussion In vitro and in vivo studies have shown the neuroprotective effects of therapeutic hypothermia for cardiac arrest. We hypothesize that longer durations of cooling may improve either the proportion of patients that attain a good neurological recovery or may result in better recovery among the proportion already categorized as having a good outcome. If the treatment effect of cooling is increasing across duration, for at least some set of durations, then this provides evidence of the efficacy of cooling itself versus normothermia, even in the absence of a normothermia control arm, confirming previous RCTs for OHCA survivors of shockable rhythms and provides the first prospective controlled evidence of efficacy in those without initial shockable rhythms. Trial registration ClinicalTrials.gov NCT04217551. Registered on 30 December 2019.

Abstract Predictors of rebound after correction of coronal plane deformities using temporary hemiepiphysiodesis (TH) are not well defined. The following research questions were tested: (1) Is the dynamic knee joint load useful to improve rebound prediction accuracy? (2) Does a large initial deformity play a critical role in rebound development? (3) Are BMI and a young age risk factors for rebound? Fifty children and adolescents with idiopathic knee valgus malalignment were included. A deviation of the mechanical femorotibial angle (MFA) of ≥ 3° into valgus between explantation and the one-year follow-up period was chosen to classify a rebound. A rebound was detected in 22 of the 50 patients (44%). Two predictors of rebound were identified: 1. reduced peak lateral knee joint contact force in the first half of the stance phase at the time of explantation (72.7% prediction); 2. minor initial deformity according to the MFA (70.5% prediction). The best prediction (75%) was obtained by including both parameters in the binary logistic regression method. A TH should not be advised in patients with a minor initial deformity of the leg axis. Dynamic knee joint loading using gait analysis and musculoskeletal modeling can be used to determine the optimum time to remove the plates.

Abstract Clade 2.3.4.4b highly pathogenic avian influenza (HPAI) H5N1 virus was detected in the South American sea lions found dead in Santa Catarina, Brazil, in October 2023. Whole genome sequencing and comparative phylogenetic analysis were conducted to investigate the origin, genetic diversity, and zoonotic potentials of the H5N1 viruses. The H5N1 viruses belonged to the genotype B3.2 of clade 2.3.4.4b H5N1 virus, which was identified in North America and disseminated to South America. They have acquired new amino acid substitutions related to mammalian host affinity. Our study provides insights into the genetic landscape of HPAI H5N1 viruses in Brazil, highlighting the continuous evolutionary processes contributing to their possible adaptation to mammalian hosts.

Abstract Objectives The oak processionary moth (OPM) (Thaumetopoea processionea) is a species of moth (order: Lepidoptera) native to parts of central Europe. However, in recent years, it has become an invasive species in various countries, particularly in the United Kingdom and the Netherlands. The larvae of the OPM are covered with urticating barbed hairs (setae) causing irritating and allergic reactions at the three last larval stages (L3-L5). The aim of our study was to generate a de novo transcriptomic assembly for OPM larvae by including one non-allergenic stage (L2) and two allergenic stages (L4 and L5). A transcriptomic assembly will help identify potential allergenic peptides produced by OPM larvae, providing valuable information for developing novel therapeutic strategies and allergic immunodiagnostic assays. Data Transcriptomes of three larval stages of the OPM were de novo assembled and annotated using Trinity and Trinotate, respectively. A total of 145,251 transcripts from 99,868 genes were identified. Bench-marking universal single-copy orthologues analysis indicated high completeness of the assembly. About 19,600 genes are differentially expressed between the non-allergenic and allergenic larval stages. The data provided here contribute to the characterization of OPM, which is both an invasive species and a health hazard.

OBJECTIVE: To evaluate the safety, feasibility, and efficacy of combined adrenergic blockade with propranolol and clonidine in patients with severe traumatic brain injury (TBI). BACKGROUND: Administration of adrenergic blockade after severe TBI is common. To date, no prospective trial has rigorously evaluated this common therapy for benefit. METHODS: This phase II, single-center, double-blinded, pilot randomized placebo-controlled trial included patients aged 16-64 years with severe TBI (intracranial hemorrhage and Glasgow Coma Scale score ≤ 8) within 24 h of ICU admission. Patients received propranolol and clonidine or double placebo for 7 days. The primary outcome was ventilator-free days (VFDs) at 28 days. Secondary outcomes included catecholamine levels, hospital length of stay, mortality, and long-term functional status. A planned futility assessment was performed mid-study. RESULTS: Dose compliance was 99%, blinding was intact, and no open-label agents were used. No treatment patient experienced dysrhythmia, myocardial infarction, or cardiac arrest. The study was stopped for futility after enrolling 47 patients (26 placebo, 21 treatment), per a priori stopping rules. There was no significant difference in VFDs between treatment and control groups [0.3 days, 95% CI (- 5.4, 5.8), p = 1.0]. Other than improvement of features related to sympathetic hyperactivity (mean difference in Clinical Features Scale (CFS) 1.7 points, CI (0.4, 2.9), p = 0.012), there were no between-group differences in the secondary outcomes. CONCLUSION: Despite the safety and feasibility of adrenergic blockade with propranolol and clonidine after severe TBI, the intervention did not alter the VFD outcome. Given the widespread use of these agents in TBI care, a multi-center investigation is warranted to determine whether adrenergic blockade is of therapeutic benefit in patients with severe TBI. Trial Registration Number NCT01322048.

Introdução/objetivos: Amostras do gênero Klebsiella, principalmente da espécie K. pneumoniae, estão os patógenos mais frequentes em infecções relacionadas à assistência em saúde e infecções invasivas adquiridas na comunidade. K. pneumoniae está entre os microrganismos mais frequentes entre amostras resistentes a múltiplas drogas. Nas últimas décadas, a resistência aos carbapenemas tem crescido, sendo associada a desfecho clínico desfavorável e aumento da morbidade e mortalidade, além do aumento dos custos de hospitalização, internações mais longas e do uso de antibióticos alternativos e mais caros. O objetivo do estudo foi caracterizar amostras de Klebsiella sp. produtoras de carbapenemases quanto aos clones que pertencem e aos genes e mutações que codificam resistência aos antimicrobianos. Materiais e métodos: 166 amostras de Klebsiella sp. produtoras de carbapenemases foram obtidas de diversos espécimes clínicos de um hospital no Rio de Janeiro entre janeiro de 2014 e janeiro de 2017 (n = 105) e março a outubro de 2020 (n = 61). Estas foram enviadas para sequenciamento do genoma completo. A identificação de espécie, MLST e genes de resistência aos antimicrobianos foram determinadas através das ferramentas on-line disponibilizadas pelo Center for Genomic Epidemiology. Resultados: Das 166 amostras do estudo 162 foram identificadas com K. pneumoniae, 3 como K. aerogenes e 1 como K. quasipneumoniae subsp. similipneumoniae. Observamos significativas mudanças clonais quando comparamos as amostras dos dois períodos (p < 0.005). Os dois STs mais frequentes em 2014-2017 (ST437 61% e ST340 11%) não foram observados no período de 2020, sendo substituídos pelo ST11 (46%), ST16 (26%) e ST258 (15%) no segundo período do estudo. Dentre os genes de resistência encontrados destacamos a presença das carbapenemases KPC-2 em 121 (73%) amostras, KPC-2 e OXA-370 em 22 (13%), OXA-370 em 11 (7%), KPC-2 e NDM-1 em 10 (6%) e NDM-1 em 2 (1%) e a ESBL CTX-M-15 em 86 (52%). Além destes, foi encontrada uma grande diversidade de genes conferindo resistência a aminoglicosídeos, trimetoprim, quinolonas, fenicóis, macrolídeos, tetraciclinas, fosfomicina, sulfonamidas e rifampicina e mutações conferindo resistência as polimixinas. Conclusões: Observamos significativa mudança clonal entre os períodos estudados e uma grande diversidade de genes que codificam resistência aos antimicrobianos, ressaltando a importância da vigilância epidemiológica de amostras produtoras de carbapenemases. Palavras-chave: Klebsiella, Klebsiella pneumoniae, Carbapenemases, KPC, OXA-48. Conflitos de interesse: Não houve conflitos de interesse. Ética e financiamentos: Aspectos éticos: Aprovado pelos Comitês de Ética em Pesquisa do HUCFF, CAAE 60433716.8.0000.5257, e da Sociedade de Ensino Superior Estácio de Sá, 39277320.5.0000. Estudo financiado por FAPERJ n.E-26/200.228/2022, INPRA/CNPq 465718/2014-0, CNPq 312205/2019-8 e CAPES 001.

Butia eriospatha (Martius ex Drude) Beccari é uma palmeira endêmica da região sul do Brasil, de valor econômico e cultural. Atualmente, a espécie está classificada como ameaçada de extinção, devido à expansão agrícola, urbanização e dificuldades de propagação da espécie. O objetivo deste trabalho foi de avaliar o efeito de fertilizantes NPK no crescimento inicial de mudas transplantadas de B. eriospatha. As mudas foram obtidas de área de regeneração natural no município de Curitibanos (SC), e transplantadas para vasos de 2,6 L contendo substrato comercial Carolina Soil®. O experimento foi conduzido em casa de vegetação, em delineamento inteiramente casualizado. Para a análise do efeito dos fertilizantes, foram utilizados sete tratamentos, sendo eles a aplicação de nitrogênio (N), fósforo (P), potássio (K), nitrogênio, fósforo e potássio (NPK), fósforo e nitrogênio (PN), nitrogênio e potássio (NK) e fósforo e potássio (PK), contendo 20 repetições cada e totalizando 140 plântulas. Os fertilizantes utilizados no experimento foram ureia, superfosfato triplo e cloreto de potássio, aplicados em períodos quinzenais. A cada bimestre foi avaliado o diâmetro de colo e altura de estipe, durante 22 meses. O melhor tratamento para o crescimento biométrico de mudas de B. eriospatha transplantadas para substrato comercial Carolina Soil® foi a associação de fósforo e nitrogênio.

IntroductionAdverse childhood experiences (ACEs) have a profound impact on children’s and adolescents’ academic performance and overall wellbeing. In contrast, positive childhood experiences help mitigate the negative effects of ACEs on health and wellbeing. Trauma-informed and social–emotional learning (SEL) programs in schools may address these impacts, with school staff playing a pivotal role in ensuring their success and influencing school outcomes. This study aimed to assess the strengths, weaknesses, and areas for improvement in the STRYV365 peak team and Brain Agents programs. The aim was to refine program implementation and determine the preliminary effects on students, teachers, and the broader school environment.MethodsTo achieve this goal, four focus groups were conducted after the program concluded, involving 17 school leaders, administrators, and teachers from four urban schools serving students in fifth through ninth grades. The audio transcripts were professionally transcribed and analyzed by four co-authors using Dedoose for inductive coding, leading to the identification of major themes and subthemes.ResultsThree key themes were identified from transcripts: school-wide perspectives of STRYV365 programs, strengths and impacts of STRVY365 programs, and suggestions for program improvement. School staff noted that the peak team was particularly engaging for students, helping them develop SEL skills and foster both peer-to-coach and peer-to-peer relationships. Additionally, the STRYV365 programs were found to enhance student–teacher relationships and staff relationships. Teachers expressed strong interest in taking a more active role in future programming.DiscussionOverall, this study highlights the importance of teacher and administrator involvement in maintaining consistent SEL activities for urban youth. The findings also suggest that short-term, 4-week SEL programs can have a positive effect on school culture, as well as on student–teacher relationships and teacher–teacher relationships.

Abstract Background We aimed to improve the image quality (IQ) of sparse-view computed tomography (CT) images using a U-Net for lung metastasis detection and determine the best tradeoff between number of views, IQ, and diagnostic confidence. Methods CT images from 41 subjects aged 62.8 ± 10.6 years (mean ± standard deviation, 23 men), 34 with lung metastasis, 7 healthy, were retrospectively selected (2016–2018) and forward projected onto 2,048-view sinograms. Six corresponding sparse-view CT data subsets at varying levels of undersampling were reconstructed from sinograms using filtered backprojection with 16, 32, 64, 128, 256, and 512 views. A dual-frame U-Net was trained and evaluated for each subsampling level on 8,658 images from 22 diseased subjects. A representative image per scan was selected from 19 subjects (12 diseased, 7 healthy) for a single-blinded multireader study. These slices, for all levels of subsampling, with and without U-Net postprocessing, were presented to three readers. IQ and diagnostic confidence were ranked using predefined scales. Subjective nodule segmentation was evaluated using sensitivity and Dice similarity coefficient (DSC); clustered Wilcoxon signed-rank test was used. Results The 64-projection sparse-view images resulted in 0.89 sensitivity and 0.81 DSC, while their counterparts, postprocessed with the U-Net, had improved metrics (0.94 sensitivity and 0.85 DSC) (p = 0.400). Fewer views led to insufficient IQ for diagnosis. For increased views, no substantial discrepancies were noted between sparse-view and postprocessed images. Conclusions Projection views can be reduced from 2,048 to 64 while maintaining IQ and the confidence of the radiologists on a satisfactory level. Relevance statement Our reader study demonstrates the benefit of U-Net postprocessing for regular CT screenings of patients with lung metastasis to increase the IQ and diagnostic confidence while reducing the dose. Key points • Sparse-projection-view streak artifacts reduce the quality and usability of sparse-view CT images. • U-Net-based postprocessing removes sparse-view artifacts while maintaining diagnostically accurate IQ. • Postprocessed sparse-view CTs drastically increase radiologists’ confidence in diagnosing lung metastasis. Graphical Abstract

Since its founding in 2013, the Young Crystallographers (YC) have become one of the most active working groups not only within their parent organization, the German Crystallographic Society (DGK), but also among other young crystallographers' groups in Europe and the world. The aim of the YC is and always has been to support early-career researchers in the diverse fields of crystallography and the rejuvenation of the field on a national scale. Over the past decade, we have curated events, platforms, and educational content tailored to foster collaboration and knowledge transfer among young crystallographers. In this article, we introduce our group and show how this active and diverse community has shaped the rejuvenation of crystallography in Germany, strengthened by the support of our national society.